Medicine and Health Sciences Commons^™

Patient Safety Escape Room: A Graduate Medical Education Simulation For Event Reporting., Gretchen Diemer, Rebecca Jaffe, Dimitrios Papanagnou, Xiao Chi Zhang, Jillian Zavodnick

Department of Emergency Medicine Faculty Papers

Introduction: Although residents are on the front lines of patient care, they enter few formal patient safety reports on the adverse events and near misses they witness. Demonstrating the rationale and mechanics of reporting may improve this.

Methods: We designed and implemented an escape room patient safety simulation to incorporate active learning, gamification, and adult learning theory into intern patient safety onboarding. Interns from all sponsoring institution programs participated, identifying, mitigating, and reporting a range of patient safety hazards. Props and faculty time were the major resources required.

Results: One hundred twenty interns participated in this simulation in June 2018. …

Knowledge Among Patients With Heart Failure: A Narrative Synthesis Of Qualitative Research, Carly Daley, Monirah Al-Abdulmunem, Richard J. Holden

Health Services and Informatics Research

Background: Patients’ knowledge of heart failure (HF) is integral to improved outcomes. However, the HF literature has not adequately explored the nature of patients’ knowledge of HF as part of their lived experience.

Objectives: We aimed to characterize the nature of patients’ knowledge of HF, in the context of living with the disease.

Methods: We conducted a narrative synthesis of qualitative studies that addressed patients’ knowledge of HF. Studies were systematically searched and retrieved from MEDLINE, CINAHL, PsycINFO and PsycARTICLES databases. Findings were synthesized using an iterative coding process carried out by multiple analysts and reported following Enhancing Transparency in …

Development Of Mechanical Ventilator Educational Brochure For Patients/Families, Cathy Palleschi, Wendy Osgood, Mark Parker

Operational Transformation

Patients on mechanical ventilation often have no memory of events while being ventilated. In addition, families during this time, are often overwhelmed and unable to retain information provided to them by caregivers.

In attempt to address these issues, a team of care providers in an tertiary academic hospital established a goal to create a mechanical educational brochure with the goal to reduce associated anxiety and improve overall understanding of information provided.

As part of a clinical transformation project, a root cause analysis was conducted and a number of countermeasures were initiated. Some of these included a survey to capture feedback …

Reduction Of Catheter Associated Urinary Tract Infections (Cauti) In A Critical Care Setting, Deborah Jackson, Lindsey Lucas, Shawn Taylor, Jonathan Archibald, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Transformation

Urinary tract infections (UTIs) are the most common type of healthcare associated infections. Seventy five percent are related to indwelling urinary catheters. These infections come with increased morbidity and mortality risk. A team of intensive care providers at a large academic tertiary medical center initiated a quality improvement project to reduce the number of CAUTIs.

Baseline data established the total number of catheter days and CAUTIs by month. A subsequent root cause analysis was completed and several counter measures were developed to include a KPI implementation to track that all intensive care providers are educated in CAUTI and creation of …

Implementation Of Trauma Service Guideline For The Use Of Phenobarbital In The Management Of The Non-Icu Trauma Patient At Risk Or Experiencing Severe Alcohol Withdrawal, Joseph Rappold, Julianne Ontengco, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Transformation

The trauma service in a large academic tertiary medical center admits a large proportion of patients with the secondary diagnosis of alcohol use disorder. Given the successful use of phenobarbital in the critical care unit for withdrawal prophylaxis and treatment of acute withdrawal, a quality improvement project was established to create and implement guidelines for the non ICU patient.

A root cause analysis demonstrated several issues to include inconsistent clinical decision documentation. As a result, several countermeasures were initiated to address the various issues.

Post implementation of countermeasures, a decrease in the amount of severe alcohol withdrawal as well as …

Sepsis Education Utilizing ‘Sepsis Alert’ Checklist To Support The Adherence Of Early Management Bundle In The Emergency Department, Jean Jun

Doctoral Dissertations and Projects

Early recognition and timely management of sepsis is a priority within hospitals due to its direct impact on patients’ outcomes. It is critical for healthcare providers to be educated and aware of the signs and symptoms of sepsis. The emergency department (ED) is the forefront of the hospital where majority of patients with sepsis are assessed and either discharged or admitted into the hospital. Therefore, it is critical for ED nurses to be educated in the early signs of sepsis and follow evidence-based practice guidelines when managing these patients. The project leader implemented a sepsis education intervention aimed at clinical …

Integration Of Suboptimal Health Status Evaluation As A Criterion For Prediction Of Preeclampsia Is Strongly Recommended For Healthcare Management In Pregnancy: A Prospective Cohort Study In A Ghanaian Population, Enoch Odame Anto, Peter Roberts, David Coall, Cornelius Archer Turpin, Eric Adua, Youxin Wang, Wei Wang

Research outputs 2014 to 2021

Background: Normotensive pregnancy may develop into preeclampsia (PE) and other adverse pregnancy complications (APCs), for which the causes are still unknown. Suboptimal health status (SHS), a physical state between health and disease, might contribute to the development and progression of PE. By integration of a routine health measure in this Ghanaian Suboptimal Health Cohort Study, we explored the usefulness of a 25-question item SHS questionnaire (SHSQ-25) for early screening and prediction of normotensive pregnant women (NTN-PW) likely to develop PE. Methods: We assessed the overall health status among a cohort of 593 NTN-PW at baseline (10–20 weeks gestation) and followed …

Creation And Implementation Of A Pediatric Advanced Practice Nurse Critical Care Fellowship Program, Bonnie Stojadinovic, Christine A. Schindler, Margaret Faut Callahan, Maureen O'Brien, Tom B. Rice, Theresa Mikhailov

College of Nursing Faculty Research and Publications

Advanced practice registered nurses (APRNs) who begin their careers in the pediatric intensive care unit (PICU) may be challenged in this practice environment. Inadequate prior experience as a staff nurse, limited opportunities for clinical placements in the PICU during graduate education, and being in a fast-paced, high-acuity practice environment without prior exposure to critically ill children are practice challenges in the PICU setting. The goal of postgraduate education training programs (fellowship programs) for the acute care pediatric nurse practitioner (ACPNP) is to prepare students to become beginner practitioners who can function effectively in the acute care setting within a few …

Curricula For Empathy And Compassion Training In Medical Education: A Systematic Review., Sundip Patel, Alexis Pelletier-Bui, Stephanie Smith, Michael Roberts, Hope Kilgannon, Stephen Trzeciak, Brian W Roberts

Faculty Scholarship for the College of Science & Mathematics

BACKGROUND: Empathy and compassion are vital components of health care quality; however, physicians frequently miss opportunities for empathy and compassion in patient care. Despite evidence that empathy and compassion training can be effective, the specific behaviors that should be taught remain unclear. We synthesized the biomedical literature on empathy and compassion training in medical education to find the specific curricula components (skills and behaviors) demonstrated to be effective.

METHODS: We searched CENTRAL, MEDLINE, EMBASE, and CINAHL using a previously published comprehensive search strategy. We screened reference lists of the articles meeting inclusion criteria to identify additional studies for potential inclusion. …

Stem Opportunities - High School 2019, Huey-Xian Kelly Wong, Madeleine Rauhauser, Annie Morgan Nelson

Honors Expanded Learning Clubs

This publication details the lesson plan for the “Opportunities in STEM” club for the summer of 2019. This club began out of a desire to educate high school students about the opportunities and careers available in the science, technology, engineering, and mathematics fields. Often, students feel that the prospect of entering a STEM field is daunting and out of their grasp. What it means to be a scientist is often unclear, and students never consider opportunities out of the fear of the unknown, particularly when science is associated with complexity and difficulty. This lesson plan integrates experiments with a wealth …

Interdisciplinary Lens On Indigenous Health Iniquities: Planning, Nursing, Anthropology, Geography, Education, Chantal Francouer, Alana Kehoe, Ivy Tran, Steven Vanloffeld, Lillian Woroniuk, Jacob Renaud

Head and Heart Posters 2019

Indigenous peoples experience poorer health outcomes on almost every measure of health and wellbeing, when compared to the rest of Canada. For decades researchers have been working independently on addressing health inequalities, yet little progress has been made on closing the gap. This Discipline-specific way of thinking is too narrow and neglects indigenous ideologies of holistic approaches to health. An interdisciplinary approach to indigenous health research provides a more collaborative and integrated opportunity to address the multidimensional aspects of health. This paper has the goals to contribute to the limited research on interdisciplinary indigenous health research.

Quality Assurance In Telehealth: Adherence To Evidence-Based Indicators., Daniel Halpren-Ruder, Anna Marie Chang, Judd E. Hollander, Anuh Shah

Department of Emergency Medicine Faculty Papers

Background: Value enhancing telehealth (TH) lacks a robust body of formal clinically focused quality assessment studies. Innovations such as telehealth must always demonstrate that it preserves or hopefully advances quality. Introduction: We sought to determine whether adherence to the evidence-based Choosing Wisely (CW) recommendations (antibiotic stewardship) for acute sinusitis differs for encounters through direct-to-consumer (DTC) telemedicine verses "in-person" care in an emergency department (ED) or an urgent care (UC) center.

Materials and Methods: Study design was a retrospective review. Patients with a symptom complex consistent with acute sinusitis treated through DTC were matched with ED and UC patients, based upon …

Local Challenges And Successes Associated With Transitioning To Sustainable Food System Practices For A West Australian Context: Multi-Sector Stakeholder Perceptions, Ros Sambell, Lesley Andrew, Stephanie Godrich, Justin Wolfgang, Dieter Vandenbroeck, Katie Stubley, Nick Rose, Lenore Newman, Pierre Horwitz, Amanda Devine

Research outputs 2014 to 2021

Large-scale food system practices have diminished soil and water quality and negatively impacted climate change. Yet, numerous opportunities exist to harness food system practices that will ensure better outcomes for human health and ecosystems. The objective of this study was to consider food Production, Processing, Access and Consumption domains, and for each determine the challenges and successes associated with progressing towards a sustainable food system. A workshop engaging 122 participants including producers, consultants, consumers, educators, funders, scientists, media, government and industry representatives, was conducted in Perth, Western Australia. A thematic analysis of statements (Successes (n = 170) or Challenges (n …

Educational Reinforcements Of And Challenges To Gender Norms In Urban Sri Lanka, Ruvani Fonseka

Faculty Research, Scholarly, and Creative Activity

Background:
In 2013, over half of surveyed Sri Lankan men and women expressed gender-inequitable attitudes equating masculinity with violence, and femininity with obedience to men. Gender-inequitable attitudes have been shown to be linked to gender-based violence (GBV) in multiple contexts.
The goal of this research was to identify points of intervention at which programmes and policies could cultivate gender-equitable attitudes among youth in Sri Lanka, with a goal of reducing GBV in adulthood.
Methods:
Over 9 months, the lead author interviewed 18 young adults (ages 18-30) in urban Sri Lanka to understand how their experiences influenced their gender identity, as …

The Top 10 Things To Know About Transfusion Medicine Before Intern Year: An Evidence-Based Course For Graduating Medical Students., Alexis R. Peedin, Irina Perjar, Marshall A. Mazepa, Marian A. Rollins-Raval, Yara A. Park, Jay S. Raval

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: Transfusion medicine (TM) knowledge varies widely among physician trainees. In addition, there have been few instances in which curricular changes have been meaningfully assessed for TM education in medical school.

Methods: We created and presented a novel lecture to improve TM knowledge for graduating medical students using eight objectives designed to reinforce critical information about blood management. Each objective was coded according to unique color schemes, fonts, and graphics to create visual associations while quickly and clearly presenting complex concepts. The validated BEST Collaborative exam was used to measure changes in student TM knowledge, while a survey was conducted …

Physical Assessment Skills In Nursing Curricula: A Scoping Review Protocol, Sherry Morrell, Jody Ralph, Natalie Giannotti, Debbie Dayus, Susan Dennison, Judy Bornais

Nursing Publications

Review objective:This review seeks to establish the current state of knowledge regarding physical assessment skills taught in nursing programs globally. It aims to explore the literature on physical assessment skills taught in nursing curricula globally, skills used by nurses in practice, skills used by students, and core physical assessment skills that are important to teach nursing students.

Physical Assessment Skills In Nursing Curricula: A Scoping Review Protocol., Sherry Morrell, Jody Ralph, Natalie Giannotti, Debbie Dayus, Susan Dennison, Judy Bornais

Nursing Publications

This review seeks to establish the current state of knowledge regarding physical assessment skills taught in nursing programs globally. It aims to explore the literature on physical assessment skills taught in nursing curricula globally, skills used by nurses in practice, skills used by students, and core physical assessment skills that are important to teach nursing students.

Simulation Enhances Soft Skills Among Inter-Professionals Participating In An International Service-Learning Experience To A Resource-Limited Country, Suzanne Trotter, Sharon Dunnivan-Mitchell

Physical Therapy Collection

Introduction: Soft skills are the hallmark of a master healthcare provider. One of the most effective ways to teach soft skills to healthcare providers is through service-learning. Evidence suggests that adding simulation as part of a service-learning team’s pre-departure training (PDT) will better prepare them to resolve ethical and cultural dilemmas often encountered in resource-limited countries, plus facilitate soft skills. We hypothesized that simulation could improve soft skills of physical and occupational therapy students and clinicians providing rehabilitation services on a one-week service-learning experience in Guatemala.

Methods: A convenience sample of 21 physical and occupational therapy students and …

Education As Important Predictor For Successful Employment In Adults With Congenital Heart Disease Worldwide., Maayke Sluman, Maayke Sluman, Silke Apers, Judith Sluiter, Karen Nieuwenhuijsen, Philip Moons, Philip Moons, Koen Luyckx, Koen Luyckx, Adrienne Kovacs, Adrienne Kovacs, Corina Thomet, Werner Budts, Junko Enomoto, Hsiao-Ling Yang, Jamie Jackson, Paul Khairy, Stephen Cook, Raghavan Subramanyan, Luis Alday, Katrine Eriksen, Mikael Dellborg, Mikael Dellborg, Malin Berghammer, Malin Berghammer, Eva Mattsson, Andrew Mackie, Samuel Menahem, Maryanne Caruana, Kathy Gosney, Alexandra Soufi, Susan Fernandes, Kamila White, Edward Callus, Shelby Kutty, Berto Bouma, Barbara Mulder

Psychology Faculty Works

Background: Conflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an impor‐ tant determinant for quality of life, we assessed this in a large international adult CHD cohort. Methods: Data from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross‐sectional APPROACH International Study. Predictors for employment and work limitations were studied using general linear mixed models. Results: Median age was 32 years (IQR 25‐42) and 94% of patients had at least a high school degree. Overall employment rate …

Telemedicine Training In Undergraduate Medical Education: Mixed-Methods Review., Shayan Waseh, Mph, Adam P. Dicker, Md, Phd, Fastro

Student Papers, Posters & Projects

BACKGROUND: Telemedicine has grown exponentially in the United States over the past few decades, and contemporary trends in the health care environment are serving to fuel this growth into the future. Therefore, medical schools are learning to incorporate telemedicine competencies into the undergraduate medical education of future physicians so that they can more effectively leverage telemedicine technologies for improving the quality of care, increasing patient access, and reducing health care expense. This review articulates the efforts of allopathic-degree-granting medical schools in the United States to characterize and systematize the learnings that have been generated thus far in the domain of …

Addressing The Educational Needs Of Occupational Therapists Regarding Sexuality In An Acute Care Setting, Hannah Burleigh

Occupational Therapy: Student Scholarship & Creative Works

Despite the knowledge that sexuality is an important factor of well-being for individuals with disabilities, occupational therapists (OTs) continue to under-address this topic with clients (McGrath & Sakellariou, 2016). Additional education on sexuality may help OTs improve their knowledge and confidence in discussing and addressing sexuality with clients during intervention. The purpose of this study is to determine the educational needs of occupational therapists working in acute care who are alumnus of Elizabethtown College to promote the discussion of sexuality in practice. The research questions of the project are: 1) Do OTs in acute care educate clients on sexuality? 2) …

The Implications Of Ace Science: A Call To Respond, Valerie Norcross

The Diana McDonald Writer's Challenge

In “The Implications of ACE Science: A Call to Respond,” Valerie Norcross employs a professional format for writing in the field of psychology. Her essay cites studies linking Adverse Childhood Experiences (ACEs) with higher mortality rates due to a range of causes. Norcross explains some of the scientific theories for why childhood traumas contribute to shorter life expectancies. She describes efforts to screen children for ACEs and interventions for diminishing the long-term detrimental health effects of ACEs.

Designing Ethakul: A Mobile Just-In-Time Learning Environment For Bioethics In Pakistan, Azra Naseem, Kulsoom Ghias, Sohail Bawani, Mohammad Ali Shahab, Sameer Nizamuddin, Waqar Kashif, Kausar S. Khan, Tashfeen Ahmad, Murad Khan

Institute for Educational Development, Karachi

In developing countries such as Pakistan, bioethics has not been included in mainstream thinking in medical education. The authors’ experiences suggest that current methods of teaching bioethics are problematic as students are unable to translate theory to practice. Alternative pedagogies, such as just-in-time learning (JiTL) using mobile devices, may be able to foster the development and implementation of ethical reasoning among nurses, doctors, and medical and nursing students. This research was conceived to determine the effectiveness of mobile JiTL – anytime, anyplace learning through mobile devices – for teaching bioethics. After obtaining ethical clearance, a participatory design (PD) approach was …

Educating Patients About Opioid Disposal: A Key Role For Perianesthesia Nurses, Katreena C. Merrill, Valynn Christina Haslam, Karlen E. (Beth) Luthy, Craig Nuttall

Faculty Publications

Purpose: To examine opioid prescription practices, patient use of opioids after laparoscopic cholecystectomy, and patient knowledge about disposal of unused medication.

Design: Mixed methods design with a chart review and structured phone interview.

Methods: Thirty-four patients were interviewed by phone and asked how many opioids were prescribed, how many excess pills they had 6 to 10 days postoperatively, and if they knew how to dispose of them.

Findings: Average number of excess pills ranged from 0 to 42 (mean = 14; SD = 11.7). Nearly half of patients (47%) perceived the prescribed quantity as “too many.” Seventy-one percent of patients …

Biomechanical Characteristics Of Lumbar Manipulation Performed By Expert, Resident, And Student Physical Therapists, Joseph M. Derian, Jo Armour Smith, Yue Wang, Wilson Lam, Kornelia Kulig

Physical Therapy Faculty Articles and Research

Background

Lumbar manipulation is a commonly used treatment for low back pain, but little research evidence exists regarding practitioner biomechanics during manipulation. Most existing evidence describes rate of force production through the hands into instrumented manikins and it is unclear how the practitioner moves their body and legs to generate this force.

Objectives

To identify and characterize important kinetic and kinematic factors in practitioners of varying experience performing lumbar manipulation in order to identify which factors distinguish experts from less experienced practitioners.

Study design

This was a cohort observational laboratory study.

Methods

43 male physical therapists (PT) and PT students …

Effects Of High-Fidelity Simulation Based On Life-Threatening Clinical Condition Scenarios On Learning Outcomes Of Undergraduate And Postgraduate Nursing Students: A Systematic Review And Meta-Analysis, Celeste Marie Alfes

Faculty Scholarship

Objective The purpose was to analyse the effectiveness of high-fidelity patient simulation (HFPS) based on life-threatening clinical condition scenarios on undergraduate and postgraduate nursing students' learning outcomes. Design A systematic review and meta-analysis were conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and its reporting was checked against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data sources PubMed, Scopus, CINAHL with Full Text, Wiley Online Library and Web of Science were searched until July 2017. Author contact, reference and citation lists were checked to obtain additional references. Study selection To be included, available full-texts …

Primary Trauma Care: A Training Course For Healthcare Providers In Developing Countries, Saqib Kamran Bakhshi, Rashid Jooma

Section of Neurosurgery

Outcomes of injury in low and middle income countries may be compromised by skill deficiencies of healthcare providers. Short subspecialty training courses can be a useful solution to skill-deficits. We report on the Primary Trauma Care programme, a 2-day course designed to train frontline health workers in resuscitation and early management of the injured with limited resources and equipment. Developed for use in weak health systems and now conducted in over 70 countries, the programme is cost-efficient with built-in design sustainability by way of early transfer of ownership to local partners to effect a cascade of trauma courses in their …

Use Of Novel Anthropomorphic Breast Ultrasound Phantoms For Radiology Resident Education, Jacinta Browne, Chris Gu, Robert Fazzio, Andrew Fagan, Donald Tradup, Nicholas Hangiandreou

Articles

Purpose: This study evaluated the training and assessment role of anthropomorphic breast ultrasound phantoms which simulated both the morphological and sonographic characteristics of breast tissue, including lesions, in a group of radiology residents at a large academic medical center. Methods: This was a prospective study involving 9 residents across all years (2^nd–4^th year) of a radiology residency program. Baseline assessments of all residents ability to detect and characterize lesions in P-I were carried out, followed by a two-hour teaching session on the same phantom. All residents underwent a post-training, final assessment on P-II to evaluate changes in …

Assessing The Use Of Social Media In Physician Assistant Education., Gregory K. Wanner, Andrew W. Phillips, Dimitrios Papanagnou, Md

Department of Emergency Medicine Faculty Papers

Objectives: This study aims to assess physician assistant (PA) students' experiences with social media (SM) as a part of their medical education.

Methods: The study is split into two phases: Phase 1- A cross-sectional survey emailed to all PA students at four PA school campuses to assess students' prior SM experiences (226 responses, 71.1% response rate); and Phase 2- Inclusion of SM educational resources, via Twitter, within lectures performed at two PA schools. A phase-2 survey assessed students' opinions of educational SM (50 responses, 59.5% response rate) and SM usage was tracked.

Results: The phase-1 survey respondents indicated that 97.3% …

Development Of A Physical Therapy Faculty Workload Measurement Tool, Wanda Nitsch, Kathleen Manella, Jodi Liphart, Cherie Peters-Brinkerhof, Terri Roberts

Education Collection

Counting credit hours is not an equitable way to measure faculty workload in physical therapy education considering online delivery with heavy workloads negatively impacting satisfaction, learning outcomes, and research productivity. The University of St. Augustine for Health Sciences (USAHS) is a graduate-level institution in the United States, with seven Doctor of Physical Therapy programs offered in four US locations. USAHS faculty workload includes 50% teaching, 20% scholarship, 30% a combination of service, administration, release, and discretionary time. The aim of this study was to develop a faculty workload measurement tool that quantifies productivity, was easy to use, and equitable. Two …